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The Young Adult Male’s Perception of Life with Inflammatory Bowel Disease and a Stoma: A Qualitative Examination

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Abstract

While the experiences of young adults with inflammatory bowel disease (IBD) and a resultant stoma have been investigated in the USA, there is a paucity of such qualitative research in Europe. In Ireland, the voices of this patient cohort have remained remarkably silent. The purpose of this study was to achieve an understanding of the lived experience as depicted by young adults with IBD and a stoma. Purposive sampling was employed. Those with a histological diagnosis of IBD and a consequential stoma within the last 12 months were approached via a letter of invitation. Of those approached, 5 male patients aged 20–30 years agreed to participate. A qualitative approach was adopted comprising a single, detailed semi-structured interview with each of the participants. Verbatim transcripts of these interviews and associated field notes were analysed using interpretative phenomenological analysis methodology. Five superordinate themes emerged from the analysis: (1) Control, (2) Secrecy, (3) Patient education and support services, (4) Difficult emotions, (5) Acceptance and growth. A universal struggle to preserve autonomy of bodily function, emotions and healthcare decisions existed among participants. Participants embraced the predictability of their stoma relative to the restraints imposed on them by their erratic pre-operative bowel habit. Moreover, participants also reinforced the importance of timely patient education in the peri-operative period to limit uncertainty and distress. This study provides a unique insight into the lived experience of young adult males with IBD and a stoma and in particular provides a greater understanding of the peri-operative education requirements of this patient cohort.

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References

  • Ackroyd, K., Fortune, D. G., Price, S., Howell, S., Sharrack, B., & Isaac, C. L. (2011). Adversarial growth in patients with multiple sclerosis and their partners: Relationships with illness perceptions, disability and distress. Journal of Clinical Psychology in Medical Settings, 18, 372–379. https://doi.org/10.1007/s10880-011-9265-0.

    Article  PubMed  Google Scholar 

  • Addolorato, G., Capristo, E., Stefanini, G. F., & Gasbarrini, G. (1997). Inflammatory bowel disease: A study of the association between anxiety and depression, physical morbidity, and nutritional status. Scandinavian Journal of Gastroenterology, 32, 1013–1021. https://doi.org/10.3109/00365529709011218.

    Article  CAS  PubMed  Google Scholar 

  • Aronovitch, S. A., Sharp, R., & Harduar-Morano, L. (2010). Quality of life for patients living with ostomies: Influence of contact with an ostomy nurse. Journal of Wound Ostomy and Continence Nursing, 37, 649–653. https://doi.org/10.1097/won.0b013e3181f90d16.

    Article  Google Scholar 

  • Ayaz-Alkaya, S. (2019). Overview of psychosocial problems in individuals with stoma: A review of literature. International Wound Journal, 16, 243–249. https://doi.org/10.1111/iwj.13018.

    Article  PubMed  Google Scholar 

  • Brocki, J. M., & Wearden, A. J. (2006). A critical evaluation of the use of interpretative phenomenological analysis (IPA) in health psychology. Psychology and Health, 21, 87–108. https://doi.org/10.1080/14768320500230185.

    Article  Google Scholar 

  • Camilleri-Brennan, J., & Steele, R. J. (2001). Objective assessment of quality of life following panproctocolectomy and ileostomy for ulcerative colitis. Annals of the Royal College of Surgeons of England, 83, 321–324.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Carlsson, E., Bosaeus, I., & Nordgren, S. (2003). What concerns subjects with inflammatory bowel disease and an ileostomy? Scandinavian Journal of Gastroenterology, 38, 978–984.

    Article  CAS  Google Scholar 

  • Drossman, D. A., Patrick, D. L., Mitchell, C. M., Zagami, E. A., & Appelbaum, M. I. (1989). Health-related quality of life in inflammatory bowel disease. Functional status and patient worries and concerns. Digestive Diseases and Sciences, 34, 1379–1386.

    Article  CAS  Google Scholar 

  • Eatough, V., & Smith, J. (2017). Interpretative phenomenological analysis. In The SAGE handbook of qualitative research in health psychology (2 ed.). London: Sage.

  • Farrokhyar, F., Marshall, J. K., Easterbrook, B., & Irvine, E. J. (2006). Functional gastrointestinal disorders and mood disorders in patients with inactive inflammatory bowel disease: Prevalence and impact on health. Inflammatory Bowel Diseases, 12, 38–46. https://doi.org/10.1097/01.mib.0000195391.49762.89.

    Article  PubMed  Google Scholar 

  • Fortune, D., Richards, H., Griffiths, C., & Main, C. (2005). Adversarial growth in patients undergoing treatment for psoriasis: A prospective study of the ability of patients to construe benefits from negative events. Psychology, Health and Medicine, 10, 44–56. https://doi.org/10.1080/13548500512331315352.

    Article  Google Scholar 

  • Fuller-Thomson, E., Lateef, R., & Sulman, J. (2015). Robust association between inflammatory bowel disease and generalized anxiety disorder: Findings from a Nationally Representative Canadian Study. Inflammatory Bowel Disease, 21, 2341–2348. https://doi.org/10.1097/MIB.0000000000000518.

    Article  Google Scholar 

  • Greenley, R. N., Hommel, K. A., Nebel, J., Raboin, T., Li, S. H., Simpson, P., & Mackner, L. (2010). A meta-analytic review of the psychosocial adjustment of youth with inflammatory bowel disease. Journal of Pediatric Psychology, 35, 857–869. https://doi.org/10.1093/jpepsy/jsp120.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hall, N. J., Rubin, G. P., Dougall, A., Hungin, A. P., & Neely, J. (2005). The fight for ‘health-related normality’: A qualitative study of the experiences of individuals living with established inflammatory bowel disease (IBD). Journal of Health Psychology, 10, 443–455. https://doi.org/10.1177/1359105305051433.

    Article  PubMed  Google Scholar 

  • Keeton, R. L., Mikocka-Walus, A., & Andrews, J. M. (2015). Concerns and worries in people living with inflammatory bowel disease (IBD): A mixed methods study. Journal of Psychosomatic Research, 78, 573–578. https://doi.org/10.1016/j.jpsychores.2014.

    Article  PubMed  Google Scholar 

  • Kelly, M. P., & Field, D. (1996). Medical sociology, chronic illness and the body. 18, 241–257. https://doi.org/10.1111/1467-9566.ep10934993.

  • Kilic, E., Taycan, O., Belli, A. K., & Ozmen, M. (2007). The effect of permanent ostomy on body image, self-esteem, marital adjustment, and sexual functioning. Turk Psikiyatri Derg, 18, 302–310.

    PubMed  Google Scholar 

  • Kimura, C. A., Kamada, I., Guilhem, D., & Fortes, R. C. (2013). Perception of sexual activities and the care process in ostomized women. Journal of Coloproctology, 33, 145–150. https://doi.org/10.1016/j.jcol.2013.05.004.

    Article  Google Scholar 

  • Kuruvilla, K., Osler, T., & Hyman, N. H. (2012). A comparison of the quality of life of ulcerative colitis patients after IPAA vs ileostomy. Diseases of the Colon and Rectum, 55, 1131–1137. https://doi.org/10.1097/dcr.0b013e3182690870.

    Article  PubMed  Google Scholar 

  • Loftus, E. V., Jr. (2004). Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology, 126, 1504–1517.

    Article  Google Scholar 

  • Manderson, L. (2005). Boundary breaches: The body, sex and sexuality after stoma surgery. Social Science and Medicine, 61, 405–415. https://doi.org/10.1016/j.socscimed.2004.11.051.

    Article  PubMed  Google Scholar 

  • Manworren, R. C. B. (1996). Developmental effects on the adolescent of a temporary ileostomy. Journal of WOCN, 23, 210–217. https://doi.org/10.1016/S1071-5754(96)90093-5.

    Article  CAS  PubMed  Google Scholar 

  • Maunder, R. G., Greenberg, G. R., Lancee, W. J., Steinhart, A. H., & Silverberg, M. S. (2007). The impact of ulcerative colitis is greater in unmarried and young patients. Canadian Journal of Gastroenterology, 21, 715–720.

    Article  CAS  Google Scholar 

  • Moser, G., Tillinger, W., Sachs, G., Genser, D., Maier-Dobersberger, T., Spiess, K., …, Gangl, A. (1995). Disease-related worries and concerns: A study on out-patients with inflammatory bowel disease. European Journal of Gastroenterology and Hepatology, 7, 853–858.

  • Neuendorf, R., Harding, A., Stello, N., Hanes, D., & Wahbeh, H. (2016). Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review. Journal of Psychosomatic Research, 87, 70–80. https://doi.org/10.1016/j.jpsychores.2016.06.001.

    Article  PubMed  Google Scholar 

  • Notter, J., & Burnard, P. (2006). Preparing for loop ileostomy surgery: Women’s accounts from a qualitative study. International Journal of Nursing Studies, 43, 147–159. https://doi.org/10.1016/j.ijnurstu.2005.02.006.

    Article  PubMed  Google Scholar 

  • O’Leary, V. E., Alday, C. S., & Ickovics, J. R. (1998). In R. G. Tedeschi, C. L. Park, & L. G. Calhoun (Eds.), Models of life change and post-traumatic growth. London: Erlbaum.

    Google Scholar 

  • Persson, E., & Hellstrom, A. L. (2002). Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery. Journal of Wound Ostomy and Continence Nursing, 29, 103–108.

    Google Scholar 

  • Savard, J., & Woodgate, R. (2009). Young peoples’ experience of living with ulcerative colitis and an ostomy. Gastroenterology Nursing, 32, 33–41. https://doi.org/10.1097/sga.0b013e3181965d40.

    Article  PubMed  Google Scholar 

  • Sinclair, L. G. (2009). Young adults with permanent ileostomies: Experiences during the first 4 years after surgery. Journal of Wound Ostomy and Continence Nursing, 36, 306–316. https://doi.org/10.1097/won.0b013e3181a1a1c5.

    Article  Google Scholar 

  • Smith, J. A., Flowers, P., & Larkin, M. (Eds.). (2009). Interpretative Phenomenological Analysis: Theory method and research (1st ed.). London: Sage.

    Google Scholar 

  • Suris, J. C., Resnick, M. D., Cassuto, N., & Blum, R. W. (1996). Sexual behavior of adolescents with chronic disease and disability. Journal of Adolescent Health, 19, 124–131. https://doi.org/10.1016/1054-139x(95)00282-w.

    Article  CAS  PubMed  Google Scholar 

  • Turnbull, G. K., & Vallis, T. M. (1995). Quality of life in inflammatory bowel disease: The interaction of disease activity with psychosocial function. American Journal of Gastroenterology, 90, 1450–1454.

    CAS  PubMed  Google Scholar 

  • Yazdanpanah, Y., Klein, O., Gambiez, L., Baron, P., Desreumaux, P., Marquis, P., …, Colombel, J. F. (1997). Impact of surgery on quality of life in Crohn’s disease. American Journal of Gastroenterology, 92, 1897–1900.

  • Zangenberg, M. S., & El-Hussuna, A. (2017). Psychiatric morbidity after surgery for inflammatory bowel disease: A systematic review. World Journal of Gastroenterology, 23, 8651–8659. https://doi.org/10.3748/wjg.v23.i48.8651.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Thanks are extended to Marie Grimes and Mary Buckley, stoma nurses at Cork University Hospital and the Mercy University Hospital respectively.

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No funding was received for this research.

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Authors

Contributions

L.H.: study design, application for ethical approval, participant recruitment, data collection, interviews, data transcription, data coding and thematic arrangement, writing up of manuscript of 1st and subsequent drafts. H.R.: study design, data coding and thematic arrangement, review and editing of manuscript. A.J.: study design, data coding and thematic arrangement, review and editing of manuscript.

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Correspondence to Lisa Horgan.

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Lisa Horgan, Helen Richards and Aislinn Joy have no conflicts of interest to declare.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Cork Regional Ethical Committee (ref ECM 4) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all participants.

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Horgan, L., Richards, H. & Joy, A. The Young Adult Male’s Perception of Life with Inflammatory Bowel Disease and a Stoma: A Qualitative Examination. J Clin Psychol Med Settings 27, 560–571 (2020). https://doi.org/10.1007/s10880-019-09695-3

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